As soon as the ultrasound technician pressed the wand against my belly, two unmistakable black sacs appeared, each housing a tiny white dot. My immediate reaction? “Noooooo!”
Twins. Oh my goodness. Rather than feeling a surge of maternal bliss, I was engulfed by sheer panic: anxiety about carrying two babies, worry about how people would perceive my situation (let’s be real—if you see a woman of a certain age pregnant with twins, you can’t help but think “IVF,” right?), and the daunting reality of transitioning from being an only child to suddenly being a mother of multiples. I understood how fortunate I was compared to those who struggle for years with infertility, and yes, I adore my little ones (who will be turning 3 soon), but at just seven weeks along, grappling with the reality that those pricey fertility treatments had worked was overwhelming. Would both survive? Would they come too early? How would I manage their care—and my own?
Growing up, I knew only one set of twins, but now, it feels like I encounter them everywhere. Whether it’s at the park, in classes, or even at the bookstore, twins are everywhere. Statistics back this up: twin births surged by an astonishing 76 percent between 1980 and 2009, with 33 out of every 1,000 births now resulting in twins. The surge is largely attributed to the advancements in fertility treatments and assisted reproductive technologies. Medications like Clomid, which stimulate egg production, combined with IUI (intrauterine insemination) and IVF (in vitro fertilization), have led to a significant increase in multiple pregnancies.
Dr. Emily Carter, a maternal-fetal medicine expert and president of the Society for Maternal-Fetal Medicine, states, “The landscape has dramatically changed. It’s quite common now to see one or two sets of triplets on the labor floor.” This rise in twin pregnancies has profound implications for expectant mothers, their children, and the medical professionals who care for them. Carrying multiples elevates the health risks for both mothers and babies throughout pregnancy and during delivery. Women expecting twins face higher chances of gestational diabetes, pre-eclampsia, and other complications, necessitating more frequent monitoring through extra prenatal visits and ultrasounds.
As a high-risk pregnancy due to age and carrying twins, I was referred to a specialized maternal-fetal medicine group rather than a standard OB. I had monthly check-ups with increasing frequency as I approached 32 weeks. My commute transformed from a quick 10-minute stroll to a daunting 30-minute trek, with navigating subway stairs becoming an exhausting challenge. Fortunately, I transitioned to working from home around 7.5 months and avoided bed rest, though I often needed a walker just to reach my front door.
Mothers of multiples are also more likely to undergo cesarean sections (C-sections), either due to health risks or when one or both babies are in a breech position. Many obstetricians today lack the training to perform vaginal breech deliveries, opting instead for C-sections. The financial implications are significant; a C-section can cost approximately $50,000, while a vaginal delivery is around $30,000, even for singleton pregnancies. In twin deliveries, each baby requires its own medical team. The increased likelihood of preterm birth also amplifies costs; mothers of twins are 13 times more likely to deliver before 32 weeks and six times more likely before 37 weeks. Consequently, many twins are born prematurely and at low birth weights, defined as under 5 lbs., 8 oz. “The average gestational age for twins is 35 weeks. We certainly see a higher rate of premature births,” notes Dr. Carter. Premature infants often require additional care in neonatal intensive care units (NICUs), further escalating the financial and emotional toll of having twins.
At 37 weeks, I was hospitalized for pre-eclampsia, insisting on waiting for my own doctor who was skilled in breech deliveries since one of my babies was breech. After a lengthy 27-hour labor, both failed induction and epidurals led me to the operating room for a C-section. Thankfully, both babies were healthy, weighing nearly 7 lbs. and over 6 lbs. respectively. Despite my meticulous planning to ensure that all our providers were in-network, the medical bills were still substantial.
It’s undeniable that pregnancies with twins or multiples often incur higher expenses than singletons. “We’re all feeling pressure to contain costs, but with multiples, there’s only so much we can do,” Dr. Carter explains. On the bright side, healthcare providers are becoming more adept at managing the complexities that come with twin pregnancies, allowing for enhanced training for residents and better care protocols for preemies. Ongoing research aims to develop solutions that might mitigate the risks inherent in multiple pregnancies. However, the truth remains: we lack definitive medical solutions for many complications associated with carrying more than one baby. “We mainly monitor and respond,” states Dr. Carter. “For better outcomes for mothers and children, it’s ultimately safer to have single births.”
The American Society for Reproductive Medicine (ASRM) concurs, advocating for a single embryo transfer for women under 35 undergoing their first or second IVF cycle, known as elective single-embryo transfer (eSET). They emphasize that the ideal outcome of an IVF procedure is the healthy birth of a singleton. Encouragingly, advancements in fertility science have stabilized the twin birth rate, which saw a slight decrease in 2011 compared to the previous year.
Dr. Carter insists, “It’s vital to reduce the incidence of multiple gestations. Prioritizing the health of babies means having them one at a time.” However, the adoption of eSET has been slow, primarily due to the high costs associated with IVF and the emotional desire of many women facing infertility to maximize their chances of having a child—even if that means risking multiples. Fertility drugs, particularly injectables, can vary in their effects based on age and individual circumstances, leading some women to take greater risks.
As fertility science continues to evolve, these trends may shift. But for now, the reality of twins is undeniable. And when I witness my daughters share a hug or comfort each other, I feel a sense of joy in their bond—even if a moment later they’re tangled in a hair-pulling match. Their love for one another is a beautiful addition to the world.
For more insights into the journey of pregnancy, consider checking out this informative resource on pregnancy and home insemination.
Summary
The rise of twin pregnancies, largely due to advancements in fertility treatments, has significant implications for health and costs. While twin pregnancies are more common today, they also come with increased risks for mothers and babies. Healthcare providers are becoming more skilled at managing these situations, but challenges remain. The trend toward safer singleton pregnancies is slowly gaining traction, emphasizing the importance of healthy births.
Leave a Reply